Euthanasia, Physician Assisted Suicide in the Netherlands in Dementia and Late Life Psychiatric Illness

2017 ◽  
Vol 41 (S1) ◽  
pp. S11-S11 ◽  
Author(s):  
M. Stek
Keyword(s):  
The Netherlands ◽  
End Of Life ◽  
Assisted Suicide ◽  
Psychiatric Illness ◽  
Psychiatric Patients ◽  
Case Reports ◽  
Oldest Old ◽  
High Threshold ◽  
Physician Assisted Suicide ◽  
Assisted Death

BackgroundAlthough controversial in many countries, in The Netherlands euthanasia or physician assisted death has increased in patients with early stages of dementia, psychiatric illness and in conditions described as ‘being tired of life’ in the oldest old. There is a strong debate about this practice in the community and among professionals often with exclamation marks ranging from medical murder to providing ultimate care.ObjectiveTo provide figures, describe current practice and debate in The Netherlands with regard to capacity evaluation in older psychiatric patients and end of life questions.MethodsReview of literature, case reports and own experience in the past decade.Result and conclusionThere are few studies on the important issue of capacity making in psychiatric patients. The research that was performed does not show that a high threshold of capacity is required for granting euthanasia. Research on physician-assisted death in early dementia is scarce. With regard to end of life questions the debate in The Netherlands is still ongoing.Disclosure of interestThe author has not supplied his declaration of competing interest.

How Health Care Institutions in the Netherlands Approach Physician Assisted Death

1996 ◽  
Vol 32 (3) ◽  
pp. 179-196 ◽  
Author(s):  
Herman H. Van Der Kloot Meijburg
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
End Of Life ◽  
Assisted Suicide ◽  
Physician Assisted Suicide ◽  
Professional Expertise ◽  
Assisted Death ◽  
Health Care Institutions ◽  
The Individual ◽  
The Way

There is a need for reassessing the specific responsibilities of health care institutions in cases of euthanasia and physician assisted suicide. For many patients health care institutions have become their end-of-life setting. With regard to patients' decisions toward the end of life, hospitals carry three responsibilities of their own: first, they must attend to the needs of the individual patient; second, they are responsible for offering professional expertise and their experience to the patient; and third, they must execute the responsibilities entrusted to them by society. In the way health care institutions cope with institutional decisions toward the end of life, they fulfill an exemplary function. In this contribution we will explore these institutional responsibilities by looking at the developments in The Netherlands.

End-of-Life Care in the Netherlands and the United States: A Comparison of Values, Justifications, and Practices

1997 ◽  
Vol 6 (2) ◽  
pp. 189-204 ◽  
Author(s):  
Timothy E. Quill ◽  
Gerrit Kimsma
Keyword(s):  
United States ◽  
The Netherlands ◽  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
Ethical Climate ◽  
The United States ◽  
Policy Implications ◽  
Life Care ◽  
Physician Assisted Suicide

Voluntary active euthanasia (VAE) and physician-assisted suicide (PAS) remain technically illegal in the Netherlands, but the practices are openly tolerated provided that physicians adhere to carefully constructed guidelines. Harsh criticism of the Dutch practice by authors in the United States and Great Britain has made achieving a balanced understanding of its clinical, moral, and policy implications very difficult. Similar practice patterns probably exist in the United States, but they are conducted in secret because of a more uncertain legal and ethical climate. In this manuscript, we plan to compare end-of-life care in the United States and the Netherlands with regard to underlying values, justifications, and practices. We will explore the risks and benefits of each system for a real patient who was faced with a common end-of-life clinical dilemma, and close with challenges for public policies in both countries.

Incidence and risk factors for euthanasia or physician-assisted suicide in oncology patients: A systematic review.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12034-12034
Author(s):  
Wei Liu ◽  
Luke Liu ◽  
Alissa Liu ◽  
Sang Jia ◽  
Tony Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
The Netherlands ◽  
Assisted Suicide ◽  
Included Study ◽  
Physician Assisted Suicide ◽  
Severe Nausea ◽  
Oncology Patients ◽  
Assisted Death ◽  
Chi Squared

12034 Background: In a growing number of jurisdictions, oncology patients may choose euthanasia or physician-assisted suicide (EPAS). A 2016 systematic review reported that 75% of U.S. and over 70% of Dutch and Belgian EPAS cases involved oncology patients. In the Netherlands and Belgium, the percentage of deaths among oncology patients via EPAS has been increasing. We investigated the incidence and risk factors for EPAS and EPAS requests in oncology patients. Methods: A systematic review was performed following PRISMA guidelines. PubMed, Embase and Cochrane databases were searched for articles from January 2000 to April 2020. Search terms were related to suicide, euthanasia, assisted dying, assisted death, right to die, mercy killing, and cancer. Eligible studies reported incidence and/or risk factors for EPAS/EPAS request based on at least 50 oncology patients. Eligibility for inclusion was independently reviewed by two authors, with discrepancies adjudicated by a third. Data obtained included: study type, country, cancer diagnosis, number of eligible patients, inclusion criteria, follow-up length, incidence of EPAS or EPAS request, and odds ratios (OR) for risk factors for EPAS and EPAS request. ORs and p values were extracted from studies whenever possible and were otherwise calculated based on the data provided using chi-squared test. Results: The search strategy identified 6519 results. 25 abstracts were selected for full-text review and 10 studies were included for analysis. All studies reported incidence of EPAS/EPAS request and 6 studies reported risk factors for EPAS/EPAS request. Six studies were from the Netherlands, 3 from Belgium, and 1 from Canada. Inclusion period for studies spanned from 1996 to 2018. Half of the included studies were prospectively conducted. Incidence of EPAS in cancer patients ranged from 7% to 15% and EPAS requests ranged from 8% to 27%. Factors significantly associated (p<0.05) with EPAS or EPAS request in any study are shown in the Table. Conclusions: Up to 15% of oncology patients choose euthanasia or physician-assisted suicide. Potentially modifiable symptoms including severe nausea, vomiting, and pain are significantly associated with EPAS in oncology patients.[Table: see text]

scholarly journals Are the Distinctions Drawn in the Debate about End-of-Life Decision Making “Principled”? If Not, How Much Does it Matter?

2012 ◽  
Vol 40 (1) ◽  
pp. 66-84 ◽  
Author(s):  
Yale Kamisar
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Good Death ◽  
Physician Assisted Suicide ◽  
Death With Dignity ◽  
Assisted Death ◽  
Dying Patients ◽  
Aid In Dying ◽  
End Of Life Decision ◽  
Life Decision

I sometimes wonder whether some proponents of physician-assisted suicide (PAS) or physician-assisted death (PAD) think they own the copyright to such catchy phrases as “death with dignity” and “a good death” so that if you are against PAS or PAD, then you must be against a dignified death or a good death. If one removes the quotation marks around phrases like “aid-in-dying” or “compassionate care for the dying,” I am not opposed to such end-of-life care either. Indeed, how could anybody be against this type of care?I do not want to abandon dying patients anymore than Dr. Timothy Quill does. Although, unfortunately, it will not always be easy to achieve the desired result, I agree with him that it ought to be a goal of medicine “to help people die well, to help them receive a good death” — or at least “the best possible” death under the circumstances. I part company with Professor Quill, however, when he urges us to change the law in the majority of our states so that in some circumstances patients may achieve a “good death” or a “dignified” one by means of lethal drugs.

Physician-assisted suicide and euthanasia in the Netherlands and Oregon

2021 ◽  
pp. 117-126
Author(s):  
Herbert Hendin ◽  
Josephine Hendin
Keyword(s):  
United States ◽  
Palliative Care ◽  
The Netherlands ◽  
Interest Groups ◽  
Assisted Suicide ◽  
The United States ◽  
Physical Illness ◽  
Physician Assisted Suicide ◽  
Assisted Death ◽  
Reporting Practices

Physician-assisted suicide (PAS) was sanctioned in Oregon in 1977, before advances in palliative care made it possible to relieve the suffering associated with serious illnesses. Depression associated with physical illness was assumed to be an inevitable consequence of terminal illnesses. These provided the impetus for legalization in Oregon which became a model for laws, implementation, and reporting practices in the United States and other countries. Since 2002, the Netherlands have had experience with PAS, as well as euthanasia. Both environments have seen an increase in patients utilizing these practices. While there is advocacy from interest groups favouring these practices, questions are raised about the use, implementation, requirements, and reporting practices. This text explores the experience of assisted death in Oregon and the Netherlands, from medical/psychological perspectives.

scholarly journals Euthanasia, Physician-Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands, 1990–1995

1996 ◽  
Vol 335 (22) ◽  
pp. 1699-1705 ◽  
Author(s):  
Paul J. van der Maas ◽  
Gerrit van der Wal ◽  
Ilinka Haverkate ◽  
Carmen L.M. de Graaff ◽  
John G.C. Kester ◽  
...  
Keyword(s):  
The Netherlands ◽  
End Of Life ◽  
Assisted Suicide ◽  
Physician Assisted Suicide ◽  
Medical Practices

scholarly journals Ethical considerations at the end-of-life care

2021 ◽  
Vol 9 ◽  
pp. 205031212110009
Author(s):  
Melahat Akdeniz ◽  
Bülent Yardımcı ◽  
Ethem Kavukcu
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
Healthcare Professionals ◽  
Ethical Decision Making ◽  
Biomedical Ethics ◽  
Artificial Nutrition ◽  
Life Care ◽  
Ethical Challenges ◽  
Physician Assisted Suicide

The goal of end-of-life care for dying patients is to prevent or relieve suffering as much as possible while respecting the patients’ desires. However, physicians face many ethical challenges in end-of-life care. Since the decisions to be made may concern patients’ family members and society as well as the patients, it is important to protect the rights, dignity, and vigor of all parties involved in the clinical ethical decision-making process. Understanding the principles underlying biomedical ethics is important for physicians to solve the problems they face in end-of-life care. The main situations that create ethical difficulties for healthcare professionals are the decisions regarding resuscitation, mechanical ventilation, artificial nutrition and hydration, terminal sedation, withholding and withdrawing treatments, euthanasia, and physician-assisted suicide. Five ethical principles guide healthcare professionals in the management of these situations.

Euthanasia and Physician-Assisted Suicide among Patients with Amyotrophic Lateral Sclerosis in the Netherlands

2002 ◽  
Vol 346 (21) ◽  
pp. 1638-1644 ◽  
Author(s):  
Jan H. Veldink ◽  
John H.J. Wokke ◽  
Gerrit van der Wal ◽  
J.M.B. Vianney de Jong ◽  
Leonard H. van den Berg
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
The Netherlands ◽  
Assisted Suicide ◽  
Physician Assisted Suicide ◽  
Lateral Sclerosis

When slippery slope arguments miss the mark: a lesson from one against physician-assisted death

2018 ◽  
Vol 44 (10) ◽  
pp. 657-660 ◽  
Author(s):  
Eric Blackstone ◽  
Stuart J Youngner
Keyword(s):  
Continuous Improvement ◽  
Assisted Suicide ◽  
Slippery Slope ◽  
Regulatory Agencies ◽  
Physician Assisted Suicide ◽  
Assisted Death ◽  
Slippery Slope Arguments ◽  
Life Sustaining Treatment ◽  
American Society ◽  
Susan Wolf

In 1989, Susan Wolf convincingly warned of a troublesome consequence that should discourage any movement in American society towards physician-assisted death—a legal backlash against the gains made for limiting life-sustaining treatment. The authors demonstrate that this dire consequence did not come to pass. As physician-assisted suicide gains a foothold in USA and elsewhere, many other slippery slope arguments are being put forward. Although many of these speculations should be taken seriously, they do not justify halting the new practice. Instead, our courts, regulatory agencies, journalists, professional organisations and researchers should carefully monitor and study it as it unfolds, allowing continuous improvement just as our society has done in implementing the practice of limiting life-sustaining treatment.

Is Presence Always Complicity? An Analysis of Presence, Its Moral Objects, and Scandal in Proximity to Physician-Assisted Suicide and Euthanasia

2021 ◽  
Vol 82 (3) ◽  
pp. 487-508
Author(s):  
Daniel Fleming
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
Moral Action ◽  
Theological Ethics ◽  
Life Care ◽  
Physician Assisted Suicide ◽  
Recent Letter ◽  
Action Intention ◽  
Catholic Theological

Catholic chaplains and clinicians who exercise their vocations in contexts wherein physician-assisted suicide and euthanasia (PAS-E) are legal may need to confront the difficult question of whether or not their presence in proximity to these acts and the processes that govern them is consistent with Catholic ethics. Debate on this question to date has focused on complicit presence and scandal. Drawing on Catholic theological ethics and the vision for end-of-life care espoused in the Congregation for the Doctrine of the Faith’s recent letter, Samaritanus Bonus, I argue that some forms of presence in proximity to PAS-E are ethically justifiable. Core to this argument are the three elements of moral action: intention, object, and circumstance, alongside efforts to mitigate the risk of scandal informed by the teaching of Aquinas.

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